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5.3.11 Male reproductive system – Table 11.1
Assessment of conditions affecting male reproductive system
The Approved Guide includes the following introductory notes concerning the male reproductive system (Tables 11.1). This table is used to assess conditions affecting the testes, prostate, penis, seminal vesicles, spermatic cord, epididymis and scrotum
Chapter 11 is designed to compensate clients for functional loss of the reproductive system and is unlike most other tables in the Guide because it requires a specific age related assessment when considering the impairment rating.
There is no clear guidance in the Act or the PI Guide to indicate what date and therefore the relevant age of a claimant that should be applied for this table. When determining an impairment rating under Table 11.1, it is linked to a decreased impairment rating with increased age.
Both MRCA and DRCA have similar legislative requirements to be met before a level of impairment is assessed:
- Has liability been accepted?
- Is there an impairment as a result of the accepted condition?
- Is the impairment permanent and stable?
If the answer is ‘Yes’ to all of these questions, an impairment rating must be assessed under the relevant Guide.
Age at Onset
With no strict legislative criteria on the age to be applied in these circumstances, there were various dates and ages that could be considered as the relevant age for an assessment under Table 11.1, including date of assessment (as discussed above), date of onset and date of stability. The most beneficial relevant date and age to be applied in these circumstances is the age of clinical onset of the reproductive condition causing an impairment assessable under Table 11.1.
The assessment of similar claims for MRCA PI and VEA DP with Chapter 10 of GARP (V & M) utilises a date of clinical onset for the assessment and determining a level of impairment because it is likely that impotence became permanent (and stable) at that time.
Clinical onset refers to the time where relevant symptoms, signs or other evidence of a condition were first present, thus enabling an appropriate medical practitioner to say that the condition first manifested at that time. The date of clinical onset must be supported by medical evidence. Clinical onset is not necessarily the date the condition was diagnosed.
During the investigations by a Delegate, medical opinion will be sought to establish the clinical onset date and the relevance of reasonable treatment prior to determining and offering an amount of compensation payable. The date of clinical onset used for the purposes of assessment should be confirmed by a medical provider and not rely on it being self-reported by the client in isolation, i.e. the claimant provides a date of when they first became aware of some feature or symptom of the condition and/or sought medical treatment.
To be beneficial to clients, and to ensure consistency and alignment where possible across the compensation frameworks, the process applied to MRCA and VEA using the age at date of clinical onset for conditions that are considered to be permanent and stable should also be used under DRCA. Therefore policy supports that a date of clinical onset is utilised for DRCA PI claims when assessing and determining a level of impairment under Table 11.1.